HCPCS G2004: Home visitMedicare rate & RVUs in Rhode Island
Reports a 60-minute post-discharge home evaluation and management visit for a beneficiary who qualifies as a new patient.
Medicare pays $166.73 for G2004 in the office in Rhode Island (Rhode Island). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What G2004 covers
G2004 describes a home visit after a beneficiary’s discharge, with the service documented at the 60-minute level for a new patient. A physician or other qualified health care professional assesses the beneficiary in the residence, such as during recovery after a hospital stay. The encounter may address current symptoms, medication use, mobility, support at home, and the need for further care.
Choose the new-patient series when the beneficiary meets the applicable new-patient definition; use the established-patient series otherwise. Document the discharge context, home setting, new-patient status, time supporting the selected level, clinical assessment, and plan. CMS assigns the code work, practice-expense, and malpractice relative value units under the Physician Fee Schedule. G2003 and G2005 are the neighboring new-patient levels for 45 and 75 minutes, respectively.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
G2004 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | $166.73 | Unavailable |
How the G2004 rate is calculated
Each of G2004’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · G2004
RVUs × geographic indexes × conversion factor
Work3.38
3.38 RVUs× 1.000 GPCI
Practice expense1.36
1.36 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
4.9000
Conversion factor
$33.4009
Medicare rate
$163.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for G2004
G2004 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · G2004
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$163.66
Higher because the practice carries its own overhead.
G2004 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- G2003Home visit
- G2003 is the 45-minute new-patient post-discharge home-visit level; G2004 is the 60-minute level.
- G2005Home visit
- G2005 is the 75-minute new-patient post-discharge home-visit level; G2004 is the 60-minute level.
- G2009Home visit
- G2009 is for an established patient at the 60-minute level. G2004 is the corresponding new-patient level.
G2004 billing questions
When should G2004 be selected instead of G2009?
Use G2004 for a qualifying new patient and G2009 for an established patient when the post-discharge home visit is documented at the 60-minute level.
How does G2004 differ from G2003 and G2005?
Those codes are the neighboring new-patient post-discharge home-visit levels: G2003 is 45 minutes and G2005 is 75 minutes. Select the level supported by the documented service time.
What documentation supports G2004?
Record that the visit occurred at the beneficiary’s home after discharge, the beneficiary’s new-patient status, the time supporting the 60-minute level, and the assessment and plan.
Can G2004 be reported for a clinic follow-up?
No. G2004 identifies a post-discharge home visit; a clinic encounter is not the home service represented by this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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